How much rates vary
Facilitymedian $257 · 10th to 90th $162 to $8,128Professionalmedian $245 · 10th to 90th $132 to $389
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $5,128.61 Median $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | None | $138.04 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $3,311.31 Typical High $4,466.84 | Facility | None | $1,412.54 | $3,311.31 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $354.81 | Professional | None | $177.83 | $229.09 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $302.00 | Professional | None | $218.78 | $251.19 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $8,128.31 Typical High $15,848.93 | Facility | None | $199.53 | $8,128.31 | $15,848.93 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $398.11 | Professional | None | $138.04 | $199.53 | $398.11 |
Pacific Source Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $269.15 | Facility | None | $154.88 | $251.19 | $269.15 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $3,019.95 Typical High $4,466.84 | Facility | None | $251.19 | $3,019.95 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $251.19 Typical High $389.05 | Professional | None | $79.43 | $251.19 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,715.19 Typical High $12,589.25 | Facility | None | $7,413.10 | $10,715.19 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $398.11 | Professional | None | $257.04 | $269.15 | $398.11 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $457.09 | Professional | None | $194.98 | $281.84 | $457.09 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where Oregon sits
The same service costs 10.7 times more in Oklahoma than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oregon· 15th of 51
$257
OK $1,413NY $132
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.